Veterans statistics: PTSD, Depression, TBI, Suicide.
The following veterans statistics are from a major study done by the RAND Corporation (full pdf of study), a study by the Congressional Research Service, the Veterans Administration, the Institute of Medicine, the US Surgeon General, and several published studies.
PTSD statistics are a moving target that is fuzzy: do you look only at PTSD diagnosed within one year of return from battle? Do you only count PTSD that limits a soldier's ability to go back into battle or remain employed, but that may have destroyed a marriage or wrecked a family? Do you look at the PTSD statistics for PTSD that comes up at any time in a person's life: it is possible to have undiagnosed PTSD for 30 years and not realize it--possibly never or until you find a way to get better and then you realize there is another way to live. When you count the PTSD statistic of "what percentage of a population gets PTSD," is your overall starting group combat veterans, veterans who served in the target country, or all military personnel for the duration of a war?
And veterans PTSD statistics get revised over time. The findings from the NVVR Study (National Vietnam Veterans' Readjustment Study, in Four Volumes) commissioned by the government in the 1980s initially found that for "Vietnam theater veterans" 15% of men had PTSD at the time of the study and 30% of men had PTSD at some point in their life. But a 2003 re-analysis found that "contrary to the initial analysis of the NVVRS data, a large majority of Vietnam Veterans struggled with chronic PTSD symptoms, with four out of five reporting recent symptoms when interviewed 20-25 years after Vietnam." (see also NVVR review)
There is a similar problem with suicide statistics. The DoD and their researchers tend to lose track of military personnel once they retire, and do not track veteran suicides for all branches of the military (see September 2015 New York Times articles on Marine suicides and a battalion-wide suicide epidemic). And, not all suicides will be counted as a military suicide (plus, is a person who drinks themselves to death committing suicide?). A recent study found U.S. veteran suicide rates to be as high as 8,000 a year. See suicide statistics (below and bottom of Suicide Prevention page).
Summary of Veterans Statistics for PTSD, TBI, Depression and Suicide.
- As of September 2014, there are about 2.7 million American veterans of the Iraq and Afghanistan wars (compared to 2.6 million Vietnam veterans who fought in Vietnam; there are 8.2 million "Vietnam Era Veterans" (personnel who served anywhere during any time of the Vietnam War)
- According to RAND, at least 20% of Iraq and Afghanistan veterans have PTSD and/or Depression. (Military counselors I have interviewed state that, in their opinion, the percentage of veterans with PTSD is much higher; the number climbs higher when combined with TBI.)
Other accepted studies have found a PTSD prevalence of 14%; see a complete review of PTSD prevalence studies, which quotes studies with findings ranging from 4 -17% of Iraq War veterans with post-traumatic stress disorder).
A comprehensive analysis, published in 2014, found that for PTSD: “Among male and female soldiers aged 18 years or older returning from Iraq and Afghanistan, rates range from 9% shortly after returning from deployment to 31% a year after deployment. A review of 29 studies that evaluated rates of PTSD in those who served in Iraq and Afghanistan found prevalence rates of adult men and women previously deployed ranging from 5% to 20% for those who do not seek treatment, and around 50% for those who do seek treatment. Vietnam veterans also report high lifetime rates of PTSD ranging from 10% to 31%. PTSD is the third most prevalent psychiatric diagnosis among veterans using the Veterans Affairs (VA) hospitals.”PTSD and comorbid AUD", Subst Abuse Rehabil. 2014; 5: 25–36, Ralevski, et al.
- 50% of those with PTSD do not seek treatment
- out of the half that seek treatment, only half of them get "minimally adequate" treatment (RAND study)
- 19% of veterans may have traumatic brain injury (TBI)
- Over 260,000 veterans from OIF and OEF so far have been diagnosed with TBI. Traumatic brain injury is much more common in the general population than previously thought: according to the CDC, over 1,700,000 Americans have a traumatic brain injury each year; in Canada 20% of teens had TBI resulting in hospital admission or that involved over 5 minutes of unconsciousness (VA surgeon reporting in BBC News)
- 7% of veterans have both post-traumatic stress disorder and traumatic brain injury
- rates of post-traumatic stress are greater for these wars than prior conflicts
- in times of peace, in any given year, about 4% (actually 3.6%) of the general population have PTSD (caused by natural disasters, car accidents, abuse, etc.)
- recent statistical studies show that rates of veteran suicide are much higher than previously thought, as much as five to eight thousand a year (22 a day, up from a low of 18-a-year in 2007, based on a 2012 VA Suicide Data Report). (See suicide prevention page). Contrary to the impression many media articles give, veteran suicide rates, although definitely higher, are not astronomically higher than civilian rates. See New York Times 2013 article, "As Suicides Rise in US, Veterans are Less of total," by James Dao.
- PTSD distribution between services for OND, OIF, and OEF: Army 67% of cases, Air Force 9%, Navy 11%, and Marines 13%. (Congressional Research Service, Sept. 2010)
- recent sample of 600 veterans from Iraq and Afghanistan found: 14% post-traumatic stress disorder; 39% alcohol abuse; 3% drug abuse. Major depression also a problem. "Mental and Physical Health Status and Alcohol and Drug Use Following Return From Deployment to Iraq or Afghanistan." Susan V. Eisen, PhD
- Oddly, statistics for veteran tobacco use are never reported alongside PTSD statistics, even though increases in rates of smoking are strongly correlated with the stress of deployment and combat, and smoking statistics show that tobacco use is tremendously damaging and costly for soldiers.
- More active duty personnel die by own hand than combat in 2012 (New York Times)
- According to September 2015 New York Times articles, some branches of the military do not keep fine-grained data, or any data at all on the suicide rates (and this must mean on the mental health as a whole) of their veterans. There are "battalion epidemics" of suicide in the military, which much higher rates of suicide and mental health problems.
Other veterans PTSD statistics references and resources:
- Findings from the National Vietnam Veterans' Readjustment Study
- Summary of ARMY STARRS finding published in JAMA in 2014. In 2008, the Army suicide rate exceeded the civilian rate (20.2 vs 19.2 per 100,000 per year, demographically matched). The military then started to investigate why and what could be done about it, forming the Army Study to Assess Risk and Resilience in Servicemembers (ARMY STARRS).
- The American Journal of Public Health has had a number of excellent articles/studies on suicide prevention as a public health initiative, and also on suicide and the military, including approaches to suicide prevention (see especially the March 2012 issue, which included "Suicide Prevention is a Winnable Battle," by Eric D. Caine)
- Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Final Assessment. Institute of Medicine. June, 2014.
- http://www.msnbc.msn.com/id/47743091/ns/technology_and_science-science/t/does-macho-culture-keep-suicidal-soldiers-seeking-help/#.T-E1NLVYv0c (suicide rates per 100,000--11 civilian; 19 military after these two wars)
- http://www.cbsnews.com/8301-18563_162-57449255/military-suicides-grow-at-sharp-rate/ (same topic; goes into one person's case; half of military suicides from those who have not gone to war)
- http://www.nationaljournal.com/thenextamerica/culture/black-women-key-to-easing-military-suicides--20120612 (importance of social support)
- Sleep problems outperform depression and hopelessness as cross-sectional and longitudinal predictors of suicidal ideation and behavior in young adults in the military Ribeiro, J D.; Pease, J L.; Gutierrez, P M.; Silva, C ; Bernert, R A. [Stanford]; Rudd, D M.; Jr., TJ E. Journal of Affective Disorders, Feb 2012 , pp 743-50 DOI: 10.1016/j.jad.2011.09.049.
See also 10-year study in JAMA Psychiatry 2014 Oct;71(10):1129-37
- http://www.sciencedaily.com/releases/2011/06/110614101116.htm (article on above study)
- may be hereditary? www.sciencedaily.com/releases/2008/06/080612070438.htm
- Prevalence and Characteristics of Suicide Ideation and Attempts Among Active Military and Veteran Participants in a National Health Survey. Robert M. Bossarte, PhD, Kerry L. Knox, PhD, Rebecca Piegari, MS, John Altieri, BS, Janet. Am J Public Health. 2012 March; 102(Suppl 1): S38–S40
- Evaluating Evidence of Risk for Suicide Among Veterans
Robert M. Bossarte, PhD; Cynthia A. Claassen, PhD; Kerry L Knox, PhD. MILITARY MEDICINE, 175. 10:703, 2010
- The Invisible Plague of Concussion by Dr. Anand Veeravagu, MD, Senior Neurosurgery Resident Stanford University and Palo Alto Veterans Hospital. BBC Sept 5, 2013
- Thank You For Your Service, Pulitzer-prize winning journalist David Finkel looks at the life of soldiers in the US, after their return from deployment. (NYT review)